Wound shields for treating enteric fistula and wound infections are known. The express purpose of these prior devices is to provide an irrigation dressing for patients as a replacement for the typical gauze type dressings. It is well known that gauze type dressings are not only messy, but result in constant re-opening of the wounds when the dressings are changed, which could cause infections and delay the healing process. Further, dressing changes usually cannot be performed by the patient alone. They are often quite painful to the patient, expensive, and not conducive to providing frequent irrigation of the wound with medical solutions.
One known prior art irrigation dressing proposed to alleviate the problems associated with gauze type dressings is shown in expired U.S. Pat. No. 3,026,874. The device taught in that patent provides a wound shield that forms a dam around a wound and includes a clear flexible plastic window or cover for observing the healing process. The dam is fabricated of a continuous loop of foam rubber. To facilitate flushing and air control, several holes are provided at selected locations along the perimeter of the shield. The device is held in place using belts and snap fasteners that are rigidly attached to the wound shield.
Although the wound shield described above is preferred over gauze dressings, the foam rubber dam is too rigid for good sealing qualities. Further, the overall wall depth of the device is too shallow to accommodate adequate irrigation solution volumes. Lastly, the dam often comes into contact with the wound thus disrupting the healing process.
A modified wound shield or irrigating dressing is shown in FIG. 1. Wound shield 2 includes a generally oval shaped dam 20 and a window 18 attached over the top of the dam 20. The shield is secured to a patient by a first belt 4 and a second belt 6. The ends of the belts 4 and 6 are rigidly connected to window 18 by snap fasteners. Dam 20 includes an irrigation aperture 3 adapted to receive a tube 10 connected on a remote end to a supply of irrigation solution 12. Dam 20 includes a drying aperture 3 adapted to receive a tube 8 connected on a remote end to a supply of oxygen, and a draining aperture 7 adapted to receive a tube 14 connected to an associated pump 16.
In use of the above device, a flow of irrigation solution constantly irrigates the wound on the patient by a timer control, patient control, or care giver control. Oxygen or air is alternately supplied into the shield to dry the wound, while pump 16 removes the irrigation solution from the enclosed area. The wound is visible through window 18 as it heals without being exposed to contaminants. The dressing can be used for about two weeks before changing is required.
The dam of the wound shield described above comprises a hollow, highly flexible tube, which is inflated with air prior to or during use. The desired firmness is obtained by controlling the pressure of air within the dam.
Although the wound dressing is modestly successful in treating patients, the device requires a fair amount of readjustment after it is installed on the patient because the dressing twists and bends with movement of the patient. This is primarily due to a lack of flexibility in the wound shield. Further, the device tends to buckle in the middle due to a lack of cross-sectional rigidity in the inflatable dam section. This causes leakage from under the wound shield as well as undesirable contact between the wound and the window.
Therefore, it would be desirable to provide an irrigation dressing that is less rigid to prevent separation from the skin of the patient as the patient moves. The irrigation dressing should not be too soft so that it crumples with patient movement.
It is also desirable to provide an irrigation dressing that can be readily used with vacuum assist closure (VAC) devices for applying a vacuum to a wound.
It is further desirable to provide an irrigation dressing system that can conform to the shape of a moving patient yet retaining its fluid containment and vacuum integrity.